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Implicit and explicit affective associations towards cannabis use in patients with recent-onset schizophrenia and healthy controls

Published online by Cambridge University Press:  17 November 2009

N. Dekker ,
A. M. Smeerdijk ,
R. W. Wiers ,
J. H. Duits ,
G. van Gelder ,
K. Houben ,
G. Schippers ,
D. H. Linszen  and
L. de Haan
N. Dekker*
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
A. M. Smeerdijk
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
R. W. Wiers
Affiliation:
Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
J. H. Duits
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
G. van Gelder
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
K. Houben
Affiliation:
Faculty of Psychology, Department of Experimental Psychology, Maastricht University, Maastricht, The Netherlands
G. Schippers
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
D. H. Linszen
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
L. de Haan
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
*
*Address for correspondence: Dr N. Dekker, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands. (Email: nienke.dekker@amc.uva.nl)
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Abstract

Background

Cannabis use is common in patients with recent-onset schizophrenia and this is associated with poor disease outcome. More insight in the cognitive-motivational processes related to cannabis use in schizophrenia may inform treatment strategies. The present study is the first known to compare implicit and explicit cannabis associations in individuals with and without psychotic disorder.

Method

Participants consisted of 70 patients with recent-onset psychotic disorder and 61 healthy controls with various levels of cannabis use. Three Single-Category Implicit Association Tests (SC-IAT) were used to assess ‘relaxed’, ‘active’ and ‘negative’ implicit associations towards cannabis use. Explicit expectancies of cannabis use were assessed with a questionnaire using the same words as the SC-IAT.

Results

There were no differences in implicit associations between patients and controls; however, patients scored significantly higher on explicit negative affect expectancies than controls. Both groups demonstrated strong negative implicit associations towards cannabis use. Explicit relaxed expectancies were the strongest predictors of cannabis use and craving. There was a trend for implicit active associations to predict craving.

Conclusions

The findings indicate that patients suffering from schizophrenia have associations towards cannabis similar to controls, but they have stronger negative explicit cannabis associations. The strong negative implicit associations towards cannabis could imply that users of cannabis engage in a behaviour they do not implicitly like. Explicit relaxing expectancies of cannabis might be an important mediator in the continuation of cannabis use in patients and controls.

Keywords

CannabiscravingImplicit Association Taskpsychosisschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 8 , August 2010 , pp. 1325 - 1336
Copyright
Copyright © Cambridge University Press 2009

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